Can your pharmacist go on a diet? And your doctor?

[Inkriql]

Let's face it, we all carry a smarty inside. We have the same wood as the president of the Government as coach of the national soccer team or we make a potato omelette that they already wanted in Betanzos. Of course, we park our innate wisdom when we need dietary advice and turn to those who understand that: family and friends - who base their knowledge on their own experience - but especially the Internet, which is a great fishing ground for almost any proposal related to food, nutrition and dietetics (and even more, of advice endorsed by a famous healthy).

However, sometimes the miracle happens and we become aware that we should consult with a meat and bone specialist, who stands in front of us and speaks to us directly (it may surprise the amount of things in a diet that actually make us fatten). To whom to turn? Almost everyone will agree that nutritionists, doctors and pharmacists are the professionals who really offer us the necessary confidence to put ourselves in their hands. But are they all equally prepared? It depends on what you are looking for.

It is true that they all have academic training in nutrition and dietetics, and as such each one defends their training. "Any pharmacist can give advice on this matter because about 15% of the contents of the Pharmacy course correspond to Nutrition (as a core subject and as related disciplines, such as Bromatology, Physiology or Biochemistry)," argues Aquilino García, national vocal of Food of the General Council of Official Pharmaceutical Colleges.

Susana Monereo, head of the Endocrinology and Nutrition service of the Gregorio Marañón Hospital in Madrid, admits that "although food is very important, until recently it has been given little relevance as a discipline and as a training in the medical career", That is why the doctors with more knowledge are the specialists in Endocrinology and Nutrition, "that we are dedicated to the feeding of the sick person", he clarifies.

The situation changed after the degree of Human Nutrition and Dietetics was created just two decades ago (a relatively new study in Spanish universities), and thus the dietitians-nutritionists have become those who have the specific training and can use the Diet as a work tool.

These three groups of professionals show that there are different ways of training in the field, but that diversity can confuse many people - disorienting on which specialist to go to - and pays the way for the intrusion to proliferate (not to mention naturopaths, experts in orthomolecular nutrition or other pseudotherapies). "There are many who have plenty of knowledge to use nutrition and food as a therapeutic tool," says Monereo; "However, not everyone knows about this, even if everyone gives advice. There is a lot of fraud, to the point that it is one of the areas of greatest professional intrusion," he denounces.
It is not the same to give advice than to put a treatment

Just think that we eat at least three times a day throughout life (if all goes well) to understand the interest at all levels raised by this issue, but knowing all its implications requires a solid training around the world. "Except for graduates in Human Nutrition and Dietetics, and certainly endocrinologists, pharmacists may be the ones who know the most and have the most complete training," says García, who is also a graduate in Human and Dietary Nutrition and vocal of the Spanish Nutrition Society. Thus, it follows that the pharmacy is a reliable place to ask for help of this type, although, the apothecary warns, "the legislation does not always enable us to develop that knowledge."

In this sense, Alma Palau, president of the General Council of Official Associations of Dietitians-Nutritionists, admits that the legislation (Order Cin / 2137/2008) allows the pharmacist to provide nutritional advice, "but, in no way indicates that he can practice as a dietitian- Nutritionist, "and the Health Professions Management Act (LOPS) gives you the reason:" Pharmacists and dietitians-nutritionists are not comparable professions in terms of their functions. "

The key is to differentiate the concepts of advice and treatment. "The first is, for example, to propose a person taking medication for high blood pressure to reduce the intake of salt in the diet," says Palau. "We give advice every day. For example, when we tell a patient who takes an oral antidiabetic to control the amount of cereals and other hydrates; if he takes the Sintrom anticoagulant that adjusts that of green leafy vegetables or if he is treated with a type of antidepressants (Imao) that avoid red wine or cured cheese, "García abounds. Each of these suggestions

What if you sell weight loss formulas?

One of the great fears underlying the debate about whether the pharmacist is the right professional to address nutritional problems, is the possible business with miracle products, confesses the president of the Council of Dietitians-Nutritionists: "Seeing the profitability of dispensing fat burners and other ineffective concoctions, linking the nutritional advice to the pharmacy office could lead to a conflict of interest in which there is a real risk that the sale will take place in front of the council.In fact, the dietitian-nutritionist and all health professions are prohibited link your professional practice with the advertising and sale of any product, to avoid it. " In this debate, endocrinologists can keep a certain distance: "We are dedicated to nutrition in the disease of those who cannot eat and those who, due to their pathology, need a special diet, such as those affected by intestinal diseases or cancer," Monereo difference .

Now both professionals can enter into competition when it comes to the treatment of obesity. The endocrinologist regrets that "everyone thinks about weight loss, without taking into account that obesity is a problem that requires specific knowledge as required by heart failure, for example," and warns that "the concept of obesity is very banalized. and we must know that there is a sick person behind whom, perhaps, should not only treat obesity, but also diabetes or a high cardiovascular risk. "

Monereo attacks "false expectations and aberrant concepts", which have a lot of belief in pseudoscience and little scientific evidence, not only in obesity, but in other fashion issues such as widespread gluten or lactose intolerances, and also against many of the nutritional supplements on which "there is much confusion, much myth and much waste of money".
With pills in between, better step on the pharmacy

Disputes aside, Palau argues that we must consider what each health profession brings. "Pharmacy and Nutrition are independent and fully autonomous professions, which can and should interact to find the best solutions for the patient. And the citizen what he needs is a single message, clear, concise and easy to put into practice." From this perspective, the president of the General Council of Official Association of Dietitians-Nutritionists continues, "the pharmacist is responsible for the advice related to the drug-nutrient interaction, since this is often not seen in the medical consultation and the food can be an enhancer or inhibitor of pharmacological action. "

Palau says that the leading organization considers an agreement, or at least a dialogue "essential," between both professions to delimit the pharmacist's functions with respect to the nutritional advice in his office, and that it should never be an individual planning of food or that we commonly know by 'putting a diet', "since it is precisely our core." And he adds: "The pharmacy professional is an ideal agent to detect possible problems and refer your clients to the doctor or the dietitian-nutritionist." Food member of the Pharmacists Council clarifies the following: "You have to look for which professional has an official degree to offer a nutritional advice. The pharmacist, the dietitian-nutritionist and the doctor are. The gym, the herbalist and other similar establishments, no. The patient has to go to a place where the professional is legally and scientifically trained. "

And in the restaurant?

Many of these places offer in their letters information about allergens and other elements present in food. Would it be convenient if, in addition to culinary techniques, cooks knew nutrition? "Of course. We don't need to study the race, but we should have knowledge," says chef Teresa Gutiérrez, owner of the Azafrán restaurant in Albacete.

The restaurateur hung up the career of Dentistry to devote herself to cooking, and after training as a chef she graduated in Human Nutrition and Dietetics. For a chef, "this training helps us make more complete menus and dishes ... Many times we sin large amounts of protein or carbohydrates that can make a menu difficult to digest, and we are not aware of this. We care that the dishes are very beautiful, that they are very good, but not of their nutritional contribution, "he acknowledges. He insists that if they have knowledge in this area, it will be easier to understand issues such as allergens in a kitchen. "I have met many times to workers who do not understand this sensitive issue well and I am sure that if we all knew some of the matter it would be much simpler." Therefore, he considers that Nutrition "should be another subject in any school or cooking training, no matter how basic the course is. We are not doctors, but we are dedicated to feeding; and people, in the end, we are what we eat".

Chef Paco Pérez, six Michelin stars, adds a nuance: "My restaurant comes to enjoy, to experience ... Not to eat on a diet." Would you like broccoli and steamed fish to be served on the day you go out for dinner?